<!DOCTYPE html>
<html lang="en"  xmlns:th="http://www.thymeleaf.org">
<head>
    <meta charset="UTF-8">
    <title>Title</title>
    <link rel="stylesheet" href="../../../../component/pear/css/pear.css" />
</head>
<body>
<form class="layui-form" action="">
    <div class="mainBox">
        <div class="main-container">
            <div class="main-container">

                <div class="layui-form-item">
                    <div class="layui-inline layui-hide">
                        <label class="layui-form-label">id</label>
                        <div class="layui-input-block">
                            <input type="text" name="id" value="" lay-verify="title" autocomplete="off" placeholder="请输入" class="layui-input">
                        </div>
                    </div>
                    <div class="layui-inline">
                        <label class="layui-form-label">养老机构</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="personInstitution" value="" lay-verify="title" autocomplete="off" placeholder="请输入" class="layui-input">
                        </div>
                    </div>

                    <div class="layui-inline">
                        <label class="layui-form-label">老人姓名</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="patientName" required  lay-verify="required" placeholder="请输入" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                </div>
                <div class="layui-form-item">
                    <div class="layui-inline">
                        <label class="layui-form-label">入住区域</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="area" lay-verify="required" autocomplete="off" placeholder="请输入" class="layui-input">
                        </div>
                    </div>

                    <div class="layui-inline">
                        <label class="layui-form-label">入住房间</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="roomNum" required  lay-verify="required" placeholder="请输入" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                </div>

                <div class="layui-form-item">
                    <div class="layui-inline">
                        <label class="layui-form-label">床位号</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="bedNum" lay-verify="required" autocomplete="off" placeholder="请输入" class="layui-input">
                        </div>
                    </div>

                    <div class="layui-inline">
                        <label class="layui-form-label">外出时间</label>
                        <div class="layui-input-block">
                            <input type="date" readonly name="outTime" required  lay-verify="required" placeholder="请输入" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                </div>

                <div class="layui-form-item">
                    <div class="layui-inline">
                        <label class="layui-form-label">回院时间</label>
                        <div class="layui-input-block">
                            <input type="date" readonly name="returnTime" lay-verify="required" autocomplete="off" placeholder="请输入" class="layui-input">
                        </div>
                    </div>

                    <div class="layui-inline">
                        <label class="layui-form-label">陪同人</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="accPerson"  value="" lay-verify="required" placeholder="请输入" autocomplete="off" class="layui-input">
                        </div>
                    </div>
                </div>
                <div class="layui-form-item">
                    <div class="layui-inline">
                        <label class="layui-form-label">批准人</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="approveman"  value="" lay-verify="required" autocomplete="off" placeholder="请输入" class="layui-input">
                        </div>
                    </div>
                </div>
                <div class="layui-form-item">
                    <div class="layui-inline">
                        <label class="layui-form-label">外出原因</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="outreason" lay-verify="required" autocomplete="off" placeholder="请输入" class="layui-input">
                        </div>
                    </div>
                    <div class="layui-inline ">
                        <label class="layui-form-label">外出状态</label>
                        <div class="layui-input-block">
                            <input type="text" readonly name="outstatus" value="" lay-verify="required" autocomplete="off" placeholder="请输入" class="layui-input">
                        </div>
                    </div>


                </div>
            </div>

        </div>
    </div>

</form>
<script src="../../../../component/layui/layui.js"></script>
<script src="../../../../component/pear/pear.js"></script>


<script>
    layui.use(['form','jquery','upload','dtree'],function(){
        let form = layui.form;
        let $ = layui.jquery;
        let upload = layui.upload;

    })
</script>
<script>
</script>
</body>
</html>
